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European cancer research focuses on the future of treatment
Liposuction surgery in Italy leads to Streptococcus Pyogenes sepsis n outbreak of serious systemic septic complications following ambulatory liposuction was reported on March 20 in Florence, Italy. The infected individuals are three previously healthy women who underwent liposuction to their lower extremities, one patient on March 18, the other two on March 19. The procedures were done by the same physician in a private surgery. Within 12–18h of surgery, prodromes of the septic syndrome developed and all three patients were
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admitted to an intensive-care unit. Two patients developed multiple organ-failure (MOF), one aged 48 years (who died on March 26) and one aged 39 years. The third patient, aged 44 ye a rs , recovered after being diagnosed with systemic inflammatory response syndrome. In one of patients with MOF blood cultures and swabs from the surgical wounds yielded group A beta haemolytic streptococci (S Pyogenes). Nothing could be isolated from the other two patients said
Fabrizio Tozzi, intensive-care physician in charge of all the patients at Santa Maria Nuova Hospital “perhaps because the patients had already been treated with antibiotics before admission”. The state magistrate is investigating the case and police sources said the surgery where the liposuctions were done was inappropriate for such work and lacked official authorisation. A breach in aseptic conditions has been suspected as the origin of the outbreak. The vehicle of infection may have been the surgical i n s t ru m e n t s , such as liposuction cannulas. B runo Simini
European cancer research focuses on the future of treatment he European Organisation for Research and Treatment of Cancer (EORTC) told its members (Brussels, 25–26 March) to increase cooperation with the pharmaceutical industry, improve translational research, focus on quality assurance, and increase inter-group and national collaborations to improve accrual in clinical trials. The conference concluded that to remain an attractive partner to the pharmaceutical industry in terms of new drug development: rapid accrual, good quality data, and high scientific standards would be key factors. The numerous anti-cancer drugs that may
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have clinical potential ensure there is a lot of competition between pharmaceutical companies. Close cooperation would be required to ensure such companies chose to work with the EORTC, and not, for example, conduct their own clinical trials. Translational research—communicating knowledge gained in the laboratory to the patient—has been an area of some success for the EORTC. It is an area of oncology that needs to be focused on concluded a conference workshop as oncologists needed to try better individualised-patient therapies. The complexity of cancer treatment strategies means that health care must
Traditional Indian medical knowledge for sale he ancient medical knowledge of the Indian Kani community is being turned into a commercial venture. The Kani, from the south Indian state of Kerala, have been given nearly 500 000 rupees as their share of the licence fee, received by the government-sponsored Tropical Botanical Garden and Research Institute (TBGRI) from Arya Vaiyda Pharmacy (AVP)—a private ayurvedic company. In 1987, scientists from the TBGRI stumbled upon the rejuvenating properties of the Arogyapacha plant (Trychopus zeylanicus), as used by the Kani. The TBGRI scientists then spent 8 years developing an ayurvedic drug (Jeevani) from the plant, which is claimed to have immunoenhancing and anti-fatigue properties. In 1995, the TBGRI sold the formula to AVP for a licence fee of one million rupees
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and a 2% royalty fee for 7 years. AVP is now being flooded with orders from around the world. International drug companies have also shown interest in the product, the business potential of which is being compared to Korea’s ginseng. But the companies are demanding wide-ranging patent rights, says P Pushpangadan, director of the TBGRI. Despite the Kani’s good fortune, government bureaucracy has prevented any money being transferred to the community for over 2 years. Now the Kani’s share of the profits have been placed in a trust fund. Pushpangadan says the Kani’s knowledge is now being used to develop two more drugs including a non-steroidal herbal sports medicine. Sanjay Kumar
be of the highest quality. Martine Piccart, chairperson of the EORTC Treatment Division, noted that for successful treatment the quality of the surgeon was vital: “it will be important for the EORTC to raise the quality of surgery in all the centres”. To monitor the quality of surgery, surgeons participating in trials could fill in forms to ensure certain essential steps have been taken. Similar systems have be used to monitor chemotherapy but not enough attention has been paid to surgery, and this must be resolved concluded Piccart. Haroon Ashraf
Trial drags on for Turkish forensic doctor
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umhur Akpinar , who has been charged with aiding an illegal organisa tion by providing fav ourable forensic repor ts, is continuing the battle to clear his name (see Lancet 1 9 9 9 ; 3 5 3 : 9 0 9 ). He attended the Ankara State Security Court on March 23 to submit further evidence including records of telephone calls. This evidence is being used to ascer tain whether he is linked to his codefendants, who may have been involved in br ing ing charges of human-r ights violations against the police. Despite his release from jail on March 6, Akpinar is unable to work because of a sim ultaneous investigation. The case is adjour ned until Apr il 20.
Kelly Morris
THE LANCET • Vol 353 • April 3,1999
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admitted to an intensive-care unit. Two patients developed multiple organ-failure (MOF), one aged 48 years (who died on March 26) and one aged 39 years. The third patient, aged 44 ye a rs , recovered after being diagnosed with systemic inflammatory response syndrome. In one of patients with MOF blood cultures and swabs from the surgical wounds yielded group A beta haemolytic streptococci (S Pyogenes). Nothing could be isolated from the other two patients said
Fabrizio Tozzi, intensive-care physician in charge of all the patients at Santa Maria Nuova Hospital “perhaps because the patients had already been treated with antibiotics before admission”. The state magistrate is investigating the case and police sources said the surgery where the liposuctions were done was inappropriate for such work and lacked official authorisation. A breach in aseptic conditions has been suspected as the origin of the outbreak. The vehicle of infection may have been the surgical i n s t ru m e n t s , such as liposuction cannulas. B runo Simini
European cancer research focuses on the future of treatment he European Organisation for Research and Treatment of Cancer (EORTC) told its members (Brussels, 25–26 March) to increase cooperation with the pharmaceutical industry, improve translational research, focus on quality assurance, and increase inter-group and national collaborations to improve accrual in clinical trials. The conference concluded that to remain an attractive partner to the pharmaceutical industry in terms of new drug development: rapid accrual, good quality data, and high scientific standards would be key factors. The numerous anti-cancer drugs that may
T
have clinical potential ensure there is a lot of competition between pharmaceutical companies. Close cooperation would be required to ensure such companies chose to work with the EORTC, and not, for example, conduct their own clinical trials. Translational research—communicating knowledge gained in the laboratory to the patient—has been an area of some success for the EORTC. It is an area of oncology that needs to be focused on concluded a conference workshop as oncologists needed to try better individualised-patient therapies. The complexity of cancer treatment strategies means that health care must
Traditional Indian medical knowledge for sale he ancient medical knowledge of the Indian Kani community is being turned into a commercial venture. The Kani, from the south Indian state of Kerala, have been given nearly 500 000 rupees as their share of the licence fee, received by the government-sponsored Tropical Botanical Garden and Research Institute (TBGRI) from Arya Vaiyda Pharmacy (AVP)—a private ayurvedic company. In 1987, scientists from the TBGRI stumbled upon the rejuvenating properties of the Arogyapacha plant (Trychopus zeylanicus), as used by the Kani. The TBGRI scientists then spent 8 years developing an ayurvedic drug (Jeevani) from the plant, which is claimed to have immunoenhancing and anti-fatigue properties. In 1995, the TBGRI sold the formula to AVP for a licence fee of one million rupees
T
1164
and a 2% royalty fee for 7 years. AVP is now being flooded with orders from around the world. International drug companies have also shown interest in the product, the business potential of which is being compared to Korea’s ginseng. But the companies are demanding wide-ranging patent rights, says P Pushpangadan, director of the TBGRI. Despite the Kani’s good fortune, government bureaucracy has prevented any money being transferred to the community for over 2 years. Now the Kani’s share of the profits have been placed in a trust fund. Pushpangadan says the Kani’s knowledge is now being used to develop two more drugs including a non-steroidal herbal sports medicine. Sanjay Kumar
be of the highest quality. Martine Piccart, chairperson of the EORTC Treatment Division, noted that for successful treatment the quality of the surgeon was vital: “it will be important for the EORTC to raise the quality of surgery in all the centres”. To monitor the quality of surgery, surgeons participating in trials could fill in forms to ensure certain essential steps have been taken. Similar systems have be used to monitor chemotherapy but not enough attention has been paid to surgery, and this must be resolved concluded Piccart. Haroon Ashraf
Trial drags on for Turkish forensic doctor
C
umhur Akpinar , who has been charged with aiding an illegal organisa tion by providing fav ourable forensic repor ts, is continuing the battle to clear his name (see Lancet 1 9 9 9 ; 3 5 3 : 9 0 9 ). He attended the Ankara State Security Court on March 23 to submit further evidence including records of telephone calls. This evidence is being used to ascer tain whether he is linked to his codefendants, who may have been involved in br ing ing charges of human-r ights violations against the police. Despite his release from jail on March 6, Akpinar is unable to work because of a sim ultaneous investigation. The case is adjour ned until Apr il 20.
Kelly Morris
THE LANCET • Vol 353 • April 3,1999